1. Field of the Invention
The present invention relates to a hand brace, designed for the conservative treatment of the carpal tunnel syndrome (CTS).
This brace can be defined as dynamic, because it not only has a simple protective and supporting action, as explained in detail below.
The carpal tunnel syndrome (CTS) affects 9.2% of women and 0.6% of men (Journal of epidemiology, 1992) and consists in the neuropathy of the median nerve during the passage through the carpal tunnel.
It is often associated with repeated professional microtrauma, more rarely with amyloid infiltration of the transverse carpal ligament, thickening of the connective tissue in rheumatoid arthritis, hypothyroidism, etc. However, in a large number of cases the CTS is idiopathic.
The main symptoms are represented by paresthesia of the hand (first 3-4 fingers) and pain of the upper limb, up to the shoulder.
Initially, the symptoms only occur during the night or in the morning after waking up. Successively, they start occurring during the day, especially in association with an intense use of the hand.
At a later stage persistent sensory deficiencies and muscular hypotrophy of the thenar eminence occur.
The treatment can be either surgical or conservative.
The surgical treatment is generally reserved to those cases with evident significant neuropathy or to those cases that do not respond to the existing conservative treatments. Generally, it consists in the resection of the transverse carpal ligament.
The conservative treatment is reserved to those cases without neuropathy or with modest neuropathy at the neurophysiological examination, in particular if the symptomatology is not progressive or significant, and in those cases in which the surgical treatment has some counterindications.
2. Description of the Related Art
Generally, the conservative treatment is scarcely successful and represented by physical therapy (ultrasounds, laser, galvanic trays, ionophoresis, etc.), braces or splints, which-with different shapes-hold the wrist articulation, with no action on fingers or metacarpal heads.
The currently existing braces that affect fingers and metacarpal heads completely differ from the brace according to the present invention and are not capable of having the same functions as the brace according to the present invention.
The brace according to the present invention is based on physiopathological principles and aspects of the CTS that are unknown in the existing literature. The brace according to the present invention comprises a bandage capable of embracing the external regions of the distal metacarpal ends of the II.degree. (index) and V.degree. (little finger) fingers, which incorporates a dorsal support, composed of a coated, internally padded plate made of semi-rigid material. The bandage supports a soft cushion shaped like a prism with cuneiform cross-section, which is capable of being situated in intermediate position between the II.degree. and the V.degree. finger, on one side, and the III.degree. (middle finger) and the IV.degree. (ring finger) finger on the other side, when the brace is worn. More exactly, the II.degree. and the V.degree. finger are located in internal position and the III.degree. and IV.degree. finger in external position with respect to the cushion.
In a preferred embodiment the brace also includes a wrist band connected to the dorsal support incorporated in the bandage with a longitudinal strap.